Caregiver Tip of the Month

As a family caregiver, you may eventually be faced with the fact that your loved one develops a terminal illness which no longer responds to treatment. If this happens, you and other members of your family may wish to consider moving your loved one into hospice care.

According to the Hospice Foundation of America,

• Hospice is a special concept of care designed to provide comfort and support to patients and their families when a life-limiting illness no longer responds to cure-oriented treatments.

• Hospice care neither prolongs life nor hastens death. Hospice staff and volunteers offer a specialized knowledge of medical care, including pain management.

• The goal of hospice care is to improve the quality of a patient's last days by offering comfort and dignity.

• Hospice care is provided by a team-oriented group of specially trained professionals, volunteers and family members.

• Hospice addresses all symptoms of a disease, with a special emphasis on controlling a patient's pain and discomfort.

• Hospice deals with the emotional, social and spiritual impact of the disease on the patient and the patient's family and friends.

• Hospice offers a variety of bereavement and counseling services to families before and after a patient's death.

Hospice Services and Expenses

Patients referred to hospice when life expectancy is approximately six months benefit most from hospice care.  While patients must have a doctor's referral to enter hospice, the patient, family and friends can initiate the process by contacting a local hospice program.

Before providing care, hospice staff meets with the patient's personal physician(s) and a hospice physician to discuss patient history, current physical symptoms and life expectancy.

After an initial meeting with physicians, hospice staff meets with both the patient and their family. They discuss the hospice philosophy, available services and expectations.

Prior to service, staff and patients also discuss pain and comfort levels, support systems, financial and insurance resources, medications and equipment needs.

A "plan of care" is developed for the patient. This plan is regularly reviewed and revised according to patient condition.

Bereavement services and counseling are typically available to loved ones for a year after the patient's death.

Medicare covers hospice care for the elderly

Hospice care is a covered benefit under Medicare for patients with a prognosis of 6 months or less. A patient can remain in hospice care beyond six months if a physician re-certifies that the patient is terminally ill.

Medicare's benefit covers all services, medications and equipment related to the illness. These include:

Physician services
Nursing services
Home health aides
Medical appliances and supplies
Spiritual, dietary, and other counseling
Continuous care during crisis periods
Trained volunteers
Bereavement services

Approximately 43 states and the District of Columbia offer hospice coverage under Medicaid.

Many private health insurance policies and HMO's offer hospice coverage and benefits.

Hospice services are covered under Champus/Tricare.

Medicare covers hospice care in the patient's home, in a hospital, or in special hospice facilities, where available.

For more information, visit the Hospice Foundation of America online.

Our visitors ask ...

Q. What does one do when Medicare will not pay a physical therapy bill, give an explanation of benefits or a denial letter so the secondary insurance can pay?

A. Call the State Health Insurance Assistance Program (SHIP) in your state. SHIP has counselors in every State and several Territories. The counselor are available to provide free one-on-one help with your Medicare questions or problems. Click on http://www.medicare.gov/contacts/static/allStateContacts.asp for how to contact a SHIP counselor in your area.

Daily Living Solutions

— products for seniors —

As we grow older, it often becomes difficult to use many everyday products because of arthritis and other conditions. If you or a loved one needs a little help – or a lot – we've selected a group of practical and affordable solutions from our affiliated merchants to help overcome those limitations.

Whether you are looking for yourself, or to help an elderly senior continue living in their own home, you'll find a wide variety of supplies and accessories – raised toilet seats, safety rails, incontinence supplies, large-handle eating utensils, pain relief, diabetic supplies, pill splitters and crushers, big-button telephones, canes, walkers, rollators, wheelchairs – and much more.

Everything is sorted into convenient categories in our Solutions for Seniors section.

Caregiving – Finding the money for care at home

A variety of resources can help pay for care at home. We discussed these resources in some detail beginning with the May 2004 issue of this newsletter and continuing each month through the August issue. To review these newsletters, simply click on Archives and select the issue you want to see.

Announcement

Our article "Elder Care 101 – First Steps" has been enhanced with new information and is now also available in a printed-friendly format. Because it is a PDF document, it requires that you have Adobe Reader installed on your computer. But, whether you do or do not have Reader installed, you can see the entire article by clicking on Elder Care 101 - First Steps. You'll find a "printer-friendly version" icon in the upper right portion of the page; click on that if you wish to download the PDF version.

Our visitors ask ...

Q. Can you supply me with a list of assisted living/nursing facilities in that "accept" Medicaid?

A. Medicaid rarely pays for Assisted Living facilities. But, for nursing homes, click on Disability and Aging Issues. Scroll down the resulting page and click on Nursing Home Information. That will take you to Medicare's Nursing Home Compare section. It will tell you which of Medicare's acceptable nursing homes also accept Medicaid patients (most do). As you'll see, you can search for nursing homes by city and state. Be patient with these Medicare pages; they can take a long time to download, even with a broadband connection. But the information is worth the wait.

Our visitors ask ...

Q. My mother is turning 65 in September and is eligible for Medicare. She currently has Blue Cross. Can you please tell me what she has to do to ensure a smooth transition? Is there an application she needs to complete? If so, where can I get this application?

A. For most people, Medicare's coverage begins on the first day of the month of their 65th birthday, even if their birthday is on the last day of the month. If they retire early and start their Social Security or Railroad Retirement benefits before turning 65, they should already be enrolled in Medicare. (But, don't assume anything; call the local Social Security office to be sure.) If the older person is not receiving Social Security benefits or Railroad Retirement benefits when they turn 65, they must enroll in Medicare at their nearest Social Security office.

Important: Sign up for Medicare 3 months before reaching age 65, even if you plan to continue working past age 65. If you don't, your Part B coverage could be delayed and you could have a higher premium.

Recommended Reading and Videos

Many excellent books and videos can help guide you through the caregiving process. For our recommendations, including a brief description of each one, click here.

The material on this site is for informational purposes only, and is intended as a supplement, not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. More